Is the GPhC premises inspection process failing on the staffing standard?

Through the calls received to our helpline and the information PDA members provide in patient safety surveys, we regularly monitor member concerns regarding working environments and the adverse systemic effect this can have on patient safety.

Mon 3rd December 2018 The PDA

One member provided us with a copy of a recent GPhC pharmacy inspection report, which illustrated some clear opportunities to support a more progressive approach to the regulation of premises, that are arguably being missed due to the process.

The GPhC inspector noted in the report that:

  • staff had been in tears telling the inspector about the problems with staffing levels
  • the pharmacy environment was pressurised
  • staff felt under pressure to meet targets to deliver pharmacy services
  • in recent dispensing error reports, staff shortages had been highlighted
  • staff had attempted to raise concerns, but this was not always successful, and they felt their concerns weren’t always listened to or acted upon, which deterred raising concerns in the future
  • the inspector had tried personally during the visit to raise the staffing concerns within the company but couldn’t get hold of the relevant people, until finally speaking with someone at head office, who assured the inspector that they would now try to contact the same people to resolve the staffing concerns.

Each of the “principles” in the GPhC’s premises standards has various “standards” which form part of it. In this case, although the staffing levels standard was not met, the principle was graded as “satisfactory” by the GPhC meaning: “staff are empowered and competent to safeguard the health, safety and wellbeing of patients and the public”.

The pharmacy was graded “satisfactory” overall but was given an action plan in relation to the standard for staffing levels. The action plan produced on behalf of the pharmacy owner said that staff would be given protected training time but that they must ensure they raise requests for cover during periods of absence, which the company would honour wherever it deemed possible.

It is worth noting that completing the GPhC’s action plan is not mandatory and more importantly the GPhC’s internal policy is not to revisit the pharmacy to check the issues have been put right. Its policy on revisits to such pharmacies (graded “satisfactory” with an action plan) is as follows:

“If the pharmacy fails to provide evidence that they have completed the action plan within 20 working days the inspector should contact them to find out why and emphasise the importance of completing it to meet the standards. The inspector should inform the pharmacy that the failure to complete the action plan will be noted on our systems and will be raised with them at the next routine inspection (or at an earlier stage if other concerns about the pharmacy come to light). The inspection should then be regarded as closed and no further follow-up activity taken. This is because, having judged the pharmacy as satisfactory, there is no direct risk to patient safety and resources can be used more efficiently by conducting other inspections under the new model and following up any action plans for poor pharmacies.”

The GPhC is inspecting pharmacies (as part of its routine inspections programme) once every 5 years on average, so typically would not reinspect the pharmacy for a significant length of time. It is unclear why the failure to meet GPhC premises standards may not, in the GPhC’s view, amount to a “direct risk to patient safety”.

We have repeatedly challenged the GPhC to improve its approach to regulating working environments in the pharmacy (see related links below).

During pharmacy inspections since November 2013, the GPhC has given 1,926 satisfactory ratings with an action plan (like the one from our member above).

Download the FOI response below

thumbnail of FOI on Pharmacy Premises Regulation

Related links

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The Pharmacists' Defence Association is an appointed representative in respect of insurance mediation activities only of
The Pharmacy Insurance Agency Limited which is registered in England and Wales under company number 2591975
and is authorised and regulated by the Financial Conduct Authority (Register No 307063)

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